Snowsports and Mountain Biking Emergencies Chapter 14 Snowsports and Mountain Biking Emergencies

Objectives (1 of 2) Describe injuries and illnesses caused by exposure to certain environmental conditions. Describe basic types of snowsports (fixed heel, free heel, snowboard, cross country, tubing) accidents and common injuries resulting from each accident type.

Objectives (2 of 2) Describe the safety aspects of modern snowsports equipment. Describe methods of preventing accidents. Describe common off-road bicycling injuries.

Snowsports Injuries Overall injury rates have declined due to: More experienced participants Better instruction Better equipment Better trail grooming

Fatalities Accident Types Fatalities/Year (average) Skiing and snowboarding 34 Lightning strikes 89 Bathtub falls 300 Auto accidents 42,000

Snowsports Risk Factors Higher participant densities Time of day Lower 1/3 of race course Snow conditions

Alpine Skiing Injuries Rates have steadily declined Relatively safe when compared with other outdoor recreational activities Mechanisms Rotational Nonrotational

Alpine Skiing Injuries (1 of 4) Ankle Boot-top fracture Spiral fractures Knee ACL sprains MCL sprains Phantom foot syndrome

Alpine Skiing Injuries (2 of 4) Thigh, hip, and pelvis Contusions Lacerations Fractures (femur, pelvis) Hand Skier’s thumb

Alpine Skiing Injuries (3 of 4) Upper extremity (nearly 11% of all injuries) Dislocations Humeral Acromioclavicular separations Fractures Clavicle Wrist (silver fork)

Alpine Skiing Injuries (4 of 4) Overuse injuries Multiple body parts Head and chest Collisions with fixed objects Leading cause in fatalities

Snowboarding Injuries Overall rate is only slightly higher than skiing Risks for beginners is nearly the same as for new skiers Riders sustain more injuries that require immediate medical attention

Snowboarding Risks When compared to skiing: Higher risk of upper extremity injury Twice the risk of fracture Males = ankle and lower leg injuries Females = wrist and knee injuries

Snowboarding MOIs MOIs are different from those in skiing Generally due to impact Historically, less formal instruction Less familiarity with mountain environment

Snowboarding Injury Types (1 of 4) Lower extremities 60% fewer than skiers “Air” leads to ACL injuries Ankle injuries are common Snowboarder’s ankle (talus fracture)

Snowboarding Injury Types (2 of 4) Abdominal, thoracic, and back Risk of spinal injuries is the same as for skiers Injuries to the spleen are more frequent Blunt thoracic trauma is 2nd leading cause in fatalities

Snowboarding Injury Types (3 of 4) Upper extremity More than 50% of all riding injuries Wrist Young, females, beginners Hand, elbow, and shoulder Male, intermediate, expert FOOSH

Snowboarding Injury Types (4 of 4) Head Rare, but leading cause in fatalities Occurs usually with a fall backward Impact to occiput Collisions

Telemark Injuries Third most popular winter sport at ski areas Newer high performance equipment has led to injuries similar to alpine skiing. Release bindings may decrease injury risks.

Nordic Skiing Various types of gear and locales Featherweight skis and boots Traditional wax or waxless skis and heavier leather boots Parabolic skis and tall plastic boots 7 million nordic skiers in U.S.

Nordic Skiing Injuries Injury rate is small, 0.5/1000 visits Common types: Cold-related, ie, frostbite, hypothermia Equal amounts of upper and lower extremity injuries caused by falls Overuse (Skier’s toe) Eye (rare) Avalanche (rare)

Snowblade Injuries New trend Easy to learn Non-release bindings Common types: Upper extremity injuries similar to snowboarders Boot-top and spiral tib/fib fractures

Tubing Injuries New trend No or limited steering No braking Common types: Head and spine Fractures, isolated and multiple Soft tissue Injuries result from collisions and rollovers

Snowmobile Injuries Common types: Lower extremity About 50% are fractures Spinal injuries Head and neck trauma Lower back pain Overuse injuries (Raynaud’s syndrome) Avalanche

Snowmobile Risk Factors Multiple riders Excessive speed Alcohol and drug use Improper equipment Night riding Unfamiliar or avalanche terrain Jumping

Mountain Biking Make up majority of bikes sold in U.S. Many ski areas promote activity. IMBA, NORBA, and NSP helped found the National Mountain Bike Patrol. Offers training in OEC, trail etiquette, and environmental issues

Mountain Biking Injuries (1 of 2) 80% of riders will be injured MOIs include high speed and steep terrain Demographics of riders and injuries Males, late teens to late 30s Multiple injuries tend to occur. 25% require medical care. 90% occur off-road. Serious head injuries are rare.

Mountain Biking Injuries (2 of 2) Common types: Abrasions, most frequent Contusions Lacerations Fractures, typically of the clavicle Often the injured will self-evacuate

Injury Prevention (1 of 2) Maintain physical conditioning. Use and maintain good equipment. Use retention devices on the slopes. Ski or ride within your ability. Attune to your surroundings. Avoid intoxication.

Injury Prevention (2 of 2) Maintain adequate nutrition. When tired or cold, stop, rest, drink, and eat. Dress appropriately. Follow your Responsibility Code. Carry survival equipment when skiing out of area. Use high-quality eyewear. If you choose to wear a helmet, assure that it fits properly and is appropriate for the activity.